Individual
SYED AZIM BUKHARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1073 HARDING MEMORIAL PKWY, SUITE A, MARION, OH 43302-6363
(740) 383-8579
(740) 387-5244
Mailing address
L-3549, COLUMBUS, OH 43260-0001
(740) 383-7927
(740) 383-7942
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
35.042809
OH
208000000X
Pediatrics Physician
35042809B
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000118378
ANTTHEM
OH
05
—
0431965
—
OH
01
—
1200699
UHC
—
01
—
311098079
TAX ID #
—
01
—
353077
SUBMITTER NO.
—
01
—
637381
AETNA
—
Enumeration date
05/02/2006
Last updated
10/07/2014
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